Prior authorization is no longer just an administrative hurdle for ASCs; it is a defining constraint on growth. As authorization requirements expand, policies shift and payer scrutiny intensifies, ...

Prior authorization (PA) is a widely used insurance mechanism intended to ensure cost-effective, evidence-based care. However, in practice, it often imposes significant administrative and clinical ...

There are 5 steps to prior authorization when looking at it from a best practice standpoint. These steps include demographics, eligibility, determination, submission, and status retrieval. Tune into ...

For beneficiaries in six states, AI could decide on some Medicare claims for non-emergency health care services.

California is one of 31 states that passed laws in 2025 limiting insurance companies’ use of prior authorization to approve ...

This article originally appeared on ProPublica. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

While commercial insurers often use prior authorization as a way to control costs, it does the opposite for patients undergoing total hip arthroplasty, according to a study presented at the 2025 ...

Zack Sigel is a writer and editor based in New York City. He has been managing editor at Policygenius and M1 Finance, where he led teams specialized in writing about business and finance, and he has ...

Physicians and other medical providers will tell you that prior authorization is out of control and has transcended any legitimate rationale.